|
KMID : 0371319620040010001
|
|
Journal of the Korean Surgical Society
1962 Volume.4 No. 1 p.1 ~ p.32
|
|
|
Open Heart Surgery with Pump-Oxygenator
|
|
李寧均/Lee, Yung Lin
李永麟/李東植/崔秉茂/鄭埈/李元浩/朴京民/Rhee, Dong Shik/Choi, Byung Moo/Chun, Choon/Lee, Won Ho/Park, Kyung Min/Cho, Yung Soon
|
|
|
Abstract
|
|
|
Some physiologic changes of extracorporeal circulation were investigated in 43 dogs, utilizing the bubble type oxygenator. The perfusion period varied from 10 to 77 minutes and the flow rate from 18 to 240. cc/kg/min. Oxygen flow was about 4 times as much as flow rate. Red and white blood cell counts and hemoglobin values decreased after perfusion. Plasma hemoglobin values were between 0 and 44 mg% after the procedure.
Na was in normal range, showing an insignificant decrease after the bypass. K increased slightly, Cl increased" and Ca decreased slightly. The variation took place in the normal range.
NPN and BUN were in normal ranges, the former showing decrease and the later slight increase. Blood sugar increased markedly from the preperfusion level. Liver function tests by total protein,A/G ratio, cephalin cholesterol flocculation test, thymol turbidity test, and bilirubin, showed no abnormal deviation from the., preperfusion alue, except that the total protein decreased moderately.
Arterial O2 saturation averaged 92%. 02 flow of 4 times the flow rate seemed to be a little inadequate in this experiment, suggesting a little higher Oz flow. Arterial C02 content was very low even before perfusion and decreased further after perfusion.
Blood pressure dropped after thoracotomy and still more after venae cavae cannulation, sometimes to a dangerously low level. With the starting of perfusion the bloodd pressure increased.
The pump should be started as soon as possible after caval cannulation to prevent the undesirable effect of prolonged hypotension. When the pump was shut off. the arterial pressure tended to increase, but not high enough to reach the preoperative level.
EKG showed no remarkable changes in cases where extracorporeal circulation went along smoothy.
Clinical experience was with the DeWall-Lillehei´s helix reservoir pump-oxygenator and five stainless steel sponge bag -oxygenators. This report consists of five congenital malformations and One acquired heart disease: One VSD, one VSD with mild infundibular stenosis and Pulmonary:´ hypertension, three markedlyv cyanotic tetrads, and one mitral insufficiency combined with aortic insufficiency: There were two adult and four pediatric patients.
Three normothermic and---three hypothermic extracorporeal -circulation procedures were performed.
Perfusion time varied from 15 to 105 minutes. Flow rates were between 80-120 cc/kg/min, for the normothermic group and between 20-60 cc/kg/min. for the hypothermic perfusion group.
One of the tetrad cases was combined-with situs inversus totalis; the clinical diagnosis-and autopsy diagnosis being identical, Anatomical-correction! was carried out in-´each case. One VSD expired 5 hours postoperatively:ivith hyperpyrexia. a rid without regaining consciousness after perfusion. Two -tetrad cases expired 2 and 3 hours postoperatively. Two adult cases expired on the table because: of .the inability to defibrillate the heart. The last case-VSD with pulmonary hypertension showed uneventful immediate postoperative, course until, 32 hours postoperatively, when pulmonary edema suddenly
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|